The varying linear accelerators each have their own requirements (e.g. leaf design, interleaf field constraints, field size, etc.) depending on their manufacturer, and these each must be commissioned and verified.

Patient immobilization and target definition must be carefully performed.

Improved imaging during treatment is important for improving QA and the emerging technology of cone-beam CT has the potential to determine patient translation and rotation relative to a pre-treatment CT scan.

In conclusion, IMRT is increasingly becoming mature and requires vigilant and extensive QA